Examining multiple sources of influence on the reading comprehension skills of children who use cochlear implants.

Children with profound deafness are at risk for serious reading difficulties. Multiple factors affect their development of reading skills, including use of cochlear implants. Further, multiple factors influence the overall success that children experience with their cochlear implants. These factors include the age at which they receive an implant, method of communication, vocabulary skills, preoperative residual hearing, and socioeconomic status. Ninety-one children with prelingual and profound hearing impairments who received cochlear implants at varying ages participated in the study. Structural equation modeling confirmed that multiple factors affected young cochlear implant users' reading comprehension skills and that there were significant associations between the predictors of reading comprehension. Pre-implant vocabulary had an indirect positive effect on reading through postimplant vocabulary, which had a direct positive effect on reading. Overall, children with stronger language skills demonstrated stronger reading outcomes. Age at implantation both directly and indirectly, through postimplant vocabulary, affected reading outcomes, and the total effect was large. Children who were younger when they received their implants tended to have higher reading comprehension scores. Socioeconomic status negatively affected reading. Children who used total communication prior to implantation tended to have stronger pre-implant vocabulary scores, but the total effect of pre-implant communication method on children's reading skills was negligible. Research and educational implications are discussed.